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May 2014 VA Hep C Treatment Guidelines
UPDATE: Feb 26, 2016-
Funding and Prioritization Status Update

UPDATE: March 2016
VA Hep C Treatment Guidelines
VA to treat all vets in system
 

By Judith Graham
VA Extends New Hepatitis C Drugs to All Veterans in Its Health System

 
Orange Count Registry
Vietnam vets blame 'jet guns' for their hepatitis C
By Lily Leung Feb. 14, 2016 
 
CBS News Investigates
Congress outraged over hepatitis C treatment VA can't afford
Dr. Raymond Schinazi played a leading role developing a drug that cures hepatitis C while working seven-eighths of his time for the VA
 
ibtimes.com| By amynordrum
 


Hepatitis C drug costing VA, DoD millions
By Patricia Kime, Staff writer
We're looking at a company who is milking a cash cow for everything it's worth," Sanders said. 
 


VA to outsource care for 180,000 vets with hepatitis C
Dennis Wagner, The Arizona Republic 12:27 a.m. EDT June 21, 2015
 


VA to outsource care for 180,000 vets with hepatitis C
, The Republic | azcentral.com 11:51 a.m. MST June 19, 2015
Dr. David Ross, the VA's director public-health pathogens programs, resigned from the working group. "I cannot in good conscience continue to work on a plan for rationing care to veterans," he wrote.
 


VA Region Stops Referring Patients To Outside Hospitals Thanks To Budget Shortfall
Michael Volpe Contributor ...According to a memo — the entire region has been forced to stop all “non-VA care” referrals due to a budget shortfall.
 

DisabledVeterans.org
OIG INVESTIGATES VA CHOICE PROGRAM PROBLEMS
Sen. Mark Kirk admitted the VA Choice Program is a failed joke in a letter to Secretary Bob McDonald despite attempts to fix it.
 

 
Denied Hep C VA dental care?
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Dried Hepatitis C Blood Exposure 11/23/2013 Weeks later inconspicuous blood transmits virus and more likely to cause accidental exposures to Hep C
 

Lack of Standards for
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1970 Jetgun Nursing Instructions
 

2014 AASLD Study Hepatitis C not an STD

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Info: Plan Backfires-
VBA Fast Letter Boost Claims
 
Legal- Fed Regs state:
Judge decision may be relied upon
Cotant v. Principi, 17 Vet.App. 116, 134 (2003),
 
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Press Release

Source: Regent Medical Ltd

Survey of AORN Congress Attendees Reveals Double Gloving Occurs 42 Percent as Much as It Should
Thursday April 7, 1:00 pm ET

- Yet Operating Room Nurses Are Very Concerned About Need to Double Glove

NEW ORLEANS, April 7 /PRNewswire/ -- Although they are "very concerned" about the need to double glove as a means of protection against potential exposure to blood and body fluids during surgery, operating room nurses at this week's Association of PeriOperative Registered Nurses (AORN) Congress in New Orleans report they only double glove 42 percent as much as they think they should.

In a random sample of approximately 1,500 operating room nurses at the AORN Congress, Regent Medical asked about double gloving issues. Regent Medical is committed to the science of protection for healthcare professionals.

One-fourth (24 percent) of operating room nurses responding to the survey indicated that they currently double glove during 100 percent of their cases. Another 26 percent of respondents say they only double glove during 10 percent of their surgical cases. However, 41 percent feel they should double glove all the time -- in 100 percent of their cases.

When asked how concerned they are about the need to double glove, 47 percent of respondents reported that they are "very concerned," while 30 percent said they were "somewhat concerned."

Only 17 percent of operating room nurses responding to the survey said their hospital or surgical facility has a protocol requiring double gloving.

Additionally, 86 percent of survey respondents said they believed that visibly seeing where a breach has occurred when it happens would be superior protection.

"Double gloving should be routinely used in major surgery," says Ronald L. Nichols, MD, William Henderson Professor of Surgery-Emeritus and Professor of Microbiology and Immunology at Tulane University School of Medicine, New Orleans. "I believe this will greatly help protect the healthcare worker and patient from exposure to microorganisms and blood borne viruses," Dr. Nichols adds.

Decreasing Risk

According to Dr. Nichols, "The most critical factors in the prevention of postoperative infections, although difficult to quantify, are the sound judgment and proper technique of the surgeon and surgical team, as well as the general health and disease state of the patient." (1)

Double gloving can significantly decrease risk. (2) Professional societies also support double gloving as a means of reducing risk in certain procedures. The Association of PeriOperative Registered Nurses states, "Wearing two pairs of gloves (i.e., double-gloving) may be indicated for some procedures to reduce the potential for contact with blood and body fluids. (3) The American College of Surgeons Committee on Operating Room Environment says, "Double gloving does help to cut down by a factor of ten the number of potential exposures ... " (4)

A healthcare professional's risk of exposure and the subsequent potential for seroconversion can be significant. Published seroconversion rates are hepatitis B virus (HBV), 1/10; hepatitis C virus (HCV), 1/20; and HIV, 1/300. (5)

"Double gloving is an important risk management tool," says Carolyn Twomey, director of clinical affairs, Regent Medical. "Industry surveys show glove failure rates vary from 11 percent to 51 percent (6), so we believe it is critical to take measures to protect both the practitioner and the patient as much as possible. Our patented Biogel® Indicator(TM) color puncture indication system is the only proven system that clearly lets you know when the outer glove has been breeched in the presence of fluid," Twomey adds. Use of a double indicator glove system results in significantly greater detection of punctures (78%) during the operation than using single glove (42%). (7)

     (1) Nichols RL. Preventing Surgical Site Infections: A Surgeon's
         Perspective.  Emerging Infectious Diseases 2001; (7)2.
     (2) Perry J, Jagger J. Lessons from an HCV-Infected Surgeon.  Bulletin of
         the American College of Surgeons 2002; 87:8-13.  Accessed at:
         http://www.facs.org/fellows)_info/bulletin/perry0302.pdf on
         September 24, 2002.  Standard and Transmission-Based Precautions.
         AORN 2002 Standards, Recommended Practices and Guidelines; AORN:2002.
     (3) AORN. 2002 Standards, Recommended Practices and Guidelines:2002.
         AORN, Inc.
     (4) ACS. Preventing Disease in the Operating Room.  Panel discussion.
         American College of Surgeons Spring Meeting.  April 29, 1998.
         Accessed at
         http://www.facs.org:80/about_college/acscomm/core/coreprev.html .
     (5) OSHA seeks plan to curb needlesticks.  The American College of
         Orthopedic Surgeons Bulletin 1998; 1 (84).
     (6) Quebbeman EJ, et al. Double Gloving: Protecting Surgeons from blood
         contamination in the operative room Archives of Surgery 1992;
         127:213-217.
     (7) Naver LPS, Gottrup F, Incidence of glove performance in
         gastrointestinal surgery and the prospective, randomized controlled
         study, Eur J Surg 2000: 166:293-295.


    About Regent Medical

Regent Medical Ltd, the only major medical glove company with an exclusively powder-free medical glove line, has been responding to the ever- changing needs of healthcare professionals since 1983 and is committed to providing the science of protection. Offering a comprehensive product line of high quality, technically advanced surgical gloves and skin antisepsis products, Regent Medical provides Biogel® powder-free, latex surgical gloves, Biogel® Skinsense(TM) powder-free, non-latex surgical gloves, Biogel® Optifit(TM) powder-free surgical gloves, HIBICLENS® antiseptic/antimicrobial skin cleanser and HIBISTAT® waterless germicidal hand rinse products. Headquartered in Norcross, GA, more information about Regent Medical can be found at http://www.regentmedical.com .


Source: Regent Medical Ltd

 

April, 1996  New England Journal of Medicine. 1996;550-560; Current Papers in Liver Disease). Ross et al. report on an outbreak of hepatitis C in a municipal hospital in Germany. ...HCV was transmitted from a patient with chronic hepatitis C undergoing surgery to an anesthesiology technician ...in the operating room. ...technician in turn infected five other patients over the next several weeks. Sequencing of the genetic material of the HCV .. suggested ... from the initial patient. ... provides evidence that HCV can be transmitted from medical personnel other than surgeons to patients. ... note that the .. technician did not use gloves while starting intravenous lines in patients